General terms and conditions
“ASSURE TON SPORT” INSURANCE – GSL CONTRACT No. ADP20181710 General Conditions of Insurance valid Information Notice in accordance with Article L.141-4 of the French Insurance Code Ref GSL / ASSTSP0918
The coverages of your contract are governed by the Insurance Code. Your contract consists of these general conditions, supplemented by your certificate. The guarantee is valid for the duration of the contract indicated on the membership certificate. Please read your general terms and conditions carefully. They clarify our respective rights and obligations and answer any questions you may have
CHAPTER 1. OVERVIEW
This document sets out the insurance and assistance benefits that will be guaranteed and provided by the Insurer to Members/Beneficiaries of the “INSURE YOUR SPORT” contract.
CHAPTER 2. DEFINITIONS
DEFINITION OF CONTRACT STAKEHOLDERS
Any individual over 18 years of age or any organisation that has signed up for the “ASSURE YOUR SPORT” contract and has received a Certificate of Insurance.
Groupe Special Lines on behalf of Groupama Rhône-Alpes Auvergne. Caisse régionale d’Assurances Mutuelles Agricoles de Rhône-Alpes Auvergne 50 rue de SaintCyr – 69251 Lyon cedex 09 – N° de SIRET 779 838 366 000 28 Company governed by the Insurance Code and subject to the Prudential Control and Resolution Authority, 4 Place de Budapest – 75436 Paris Cedex 09
Mutuaide assistance-8-14 Avenue des Frères LUMIERE 94368 BRY-SUR MARNE Cedex-S.A. Capital of €9,590,040 fully paid-company governed by the insurance code, registered in the register of Commerce and the company under the reference RCS 383 974 086 Créteil and submitted to the prudential and resolution supervisory authority, 4 place de Budapest-75436 Paris Cedex 09.
ASSURE TON SPORT, 91 chemin des Crans, 84410 BEDOIN on behalf of its members who so request, and who hereby undertake to pay the insurance premium.
– Within the framework of an individual membership: The Member/Beneficiary mentioned on the Certificate of Membership; – In the context of a group membership: the Member/Beneficiary, persons who are members of the same association, club, or family, or employees of the same employer, engaged in the same sporting activity, for the same dates, at the same place and under the same conditions as mentioned on the Certificate of Membership
– “INSURE YOUR SPORT” Classic – “INSURE YOUR SPORT “Motor sports (*) (Classic + motor sports (*)) – “INSURE YOUR SPORT “Air sports (*) (Classic + motor sports (*) + air sports (*)) (*) As defined in Appendix 1 of this information notice to the collective contract ADP20181710, which is the general conditions.
Document given to the Member/Beneficiary after receipt of the application, payment of the Assessment and acceptance by the Insurer.
The primary and usual place of residence of the Member/Beneficiary
GEOGRAPHICAL COVERAGE :
The guarantees of the “INSURE YOUR SPORT” contract apply worldwide, excluding countries in a state of civil or foreign war, notorious political instability, people’s movements, riots, acts of terrorism, reprisals, restrictions on the free movement of persons and goods (for any reason, including health, security, weather, etc.) or disintegration of the atomic nucleus.
DURATION OF COVERAGES:
The “INSURE YOUR SPORT” contract takes effect on the effective date mentioned on the Certificate of Membership at the time and date mentioned on the Certificate of Membership, subject to receipt of the Contribution. It ceases on the date mentioned on the Certificate of Membership and no later than 12 months after it takes effect. In no event shall the effective date be earlier than the date of enrolment and payment of the Contribution. It is the responsibility of the Member/Beneficiary to verify that his Contribution has been received by the Insurer via the Subscriber.
The Premium is payable in advance at enrolment for the duration of the guarantee retained. Taxes at the current rate are included in the Premium.
FIELDS OF APPLICATION:
The guarantees are valid only within the framework of the practice of sports activities on a private basis during the period of validity of the contract mentioned on the Certificate of Membership.
All sports as defined in Appendix 1 of this information notice to the collective contract ADP20181710 are subject to the general conditions except as excluded in point IV and in Appendix 1 of this information notice.
Any unintentional physical expectation on the part of the Member/Beneficiary arising from a sudden, unforeseeable event outside the control of the Member/Beneficiary
Death not related to an illness, but to an accident during the practice of sports activities in a private capacity and resulting from the sudden action of an external, unpredictable and sudden cause.
Part of the indemnity to be paid by the Member/Beneficiary.
Random event of such a nature as to commit the guarantees of the “INSURE YOUR SPORT” contract
CHAPTER 3 : DESCRIPTION OF GUARANTEES
3.1. INSURANCE GUARANTEES
3.1.1. CANCELLATION AND INTERRUPTION OF STAY
• The Insurer guarantees the reimbursement of cancellation penalties for expenses incurred including: hotel, holiday rental, internships and sports courses, lift passes and sports equipment rental. This cancellation notified BEFORE THE DEPARTURE must be due to the occurrence, subsequent to the accession to the “INSURE YOUR SPORT” contract, of one of the following events:
• Serious accident related to sports practice requiring hospitalization
• Death due to an accident while playing sports.
ATTENTION: If membership of the “INSURE YOUR SPORT” contract is signed after the occurrence of the reason for cancellation of the trip and the Member/Beneficiary was aware of it, the Member/Beneficiary will not be entitled to claim compensation.
INSURED AMOUNT: The indemnity due under this guarantee may not exceed the actual amount of penalties invoiced following the cancellation of the trip within the limit of the amount mentioned in the table of guarantees in Annex 2 of these general conditions according to the guarantee formula subscribed. Application fees, taxes, and any travel insurance premiums are not refundable. A deductible of 50€ per person will be deducted from the indemnity paid by the Insurer.
b) Interruption of stay In the event of an accident related to the sports practice of the Member/Beneficiary leading to an interruption of stay and repatriation organised by the Assistants or leading to the obligation duly certified by the Assistants to keep the room, the Insurer shall reimburse, on presentation of original supporting documents: the ski pass, lessons, the rental of sports equipment, on a pro rata basis, within the limit of the amount mentioned in the table of benefits in Appendix 2 of these general conditions according to the guarantee formula subscribed.
3.1.2. BROKEN SKIS, SNOWBOARDING, WINDSURFING, SURFING
In the event of damage to standard equipment: skis, snowboard, windsurfing or surfing belonging to the Member/Beneficiary, the Insurer will cover the rental of equipment equivalent to that damaged for a maximum period of 8 days from a sports equipment rental company. The broken equipment must have a market value greater than or equal to 100€ at the time of the loss. To benefit from this guarantee, the Member/Beneficiary must justify by any means the breakage of the equipment and present the equipment rental invoice to the lessor.
3.1.3. PERSONAL ACCIDENT
a) DEATH INDEMNITY
In the event of the death of a Member/Beneficiary as a result of a covered accident, the insurer guarantees the payment of an indemnity to the beneficiaries, the amount of which is mentioned in the table of benefits in Appendix 2 of these general conditions according to the coverage formula subscribed. In the event of permanent disability followed by death due to the same accidental event, the amount of compensation due for death will be paid after deduction of the damage already paid under the Permanent Disability benefit. This guarantee is not granted for any minor child and is limited to €10,000 for others.
b) COMPENSATION FOR TOTAL OR PARTIAL PERMANENT DISABILITY GREATER THAN
30% This coverage provides for the payment of a maximum indemnity in the event of total permanent disability resulting from an accident occurring during the coverage period, the amount of which is mentioned in the table of benefits in Appendix 2 of these general conditions according to the coverage formula subscribed. For disability rates below 100%, the amount paid is calculated in accordance with the company’s scale. No compensation is paid for a PPI rate less than or equal to 30%.
3.2. ASSISTANCE GUARANTEES
IMPORTANT TO NOTE:
Any request for assistance must,
under penalty of inadmissibility, be made directly by the ASSURANT (or any person acting on its behalf) by all means specified below:
BY TELEPHONE: From within France: 01.55.98.57.35 From abroad: (+33) 184.108.40.206.35
The services guaranteed by this agreement may only be triggered with the prior agreement of GROUPAMA ASSISTANCE. Consequently, no expenditure made by the Beneficiaries/Insurers may be reimbursed by GROUPAMA ASSISTANCE.
In order for the assistance benefits to apply, the Insured must, before any intervention involving the assistance benefits, contact GROUPAMA ASSISTANCE, whose telephone number is given above.
GROUPAMA ASSISTANCE can under no circumstances replace local emergency relief organizations.
In all cases, the decision to provide assistance belongs exclusively to the GROUPAMA ASSISTANCE doctor, after contact with the attending doctor on site and possibly the Insured’s family.
Only the medical authorities are empowered to decide on repatriation, choice of means of transport and place of hospitalization.
Reservations are made by GROUPAMA ASSISTANCE.
Repatriation, as well as the most appropriate means of transport, are decided and chosen by GROUPAMA ASSISTANCE.
3.2.1. REPATRIATION OR MEDICAL TRANSPORT
If the Insured’s condition requires medical care or specific examinations that cannot be carried out on site, GROUPAMA ASSISTANCE organizes and takes care of:
– Either transport to a regional hospital centre or to a country likely to provide care.
– Or repatriation to the Insured’s Home if there is no suitable medical centre nearer.
– Depending on the seriousness of the case, repatriation or transport shall be carried out, under medical supervision if necessary, by the most appropriate means: medical aircraft, regular airline aircraft, train, sleeper, ship, ambulance.
In the event that hospitalization on arrival is not essential, transport is provided to the Insured’s home.
If the hospitalisation could not be done in an establishment close to home, GROUPAMA ASSISTANCE organises andpays, when its state of health allows it, for the transport of the Insured from this hospital to home.
If the hospitalisation must exceed seven days, and if no one remains at the bedside of the Insured, GROUPAMA ASSISTANCE will cover the transport costs from metropolitan France or the Insured’s Domicile (by 1st class train or economy class plane) of a person designated by the Insured.
3.2.2. REPATRIATION OF PERSONS ACCOMPANYING
If the persons accompanying the Member/Beneficiary are
covered by the same contract and can no longer return
home by the means initially provided for, GROUPAMA ASSISTANCE organizes and the Insurer pays for their return.
The transport tickets that have not been used for the return
then become the property of the Insurer.
3.2.3. HEALTH CARE COSTS
In the event of an accident related to the practice of sport, which occurs during the period of validity of the guarantees and following a guaranteed activity, this guarantee provides for the payment of medical, pharmaceutical and hospitalisation expenses up to the amount mentioned in the table of guarantees in Annex 2 to these general conditions according to the guarantee formula subscribed. The Member/Beneficiary may, on presentation of supporting
documents, and within the limit of the actual costs remaining to be paid, after reimbursement by the social security system, and of any insurance and supplementary pension scheme, submit a file to the Insurer in order to be reimbursed for thecosts remaining to be paid by him.
The additional cost of glasses and dental prostheses is limited to 100 €.
Rehabilitation and physiotherapy costs only after fracturesand/or surgical operations are reimbursed up to a maximum of 350 €.
When the Insurer intervenes first in the absence of medical insurance or social security coverage, a deductible of 250 € will be applied.
3.2.4. SEARCH AND RESCUE COSTS
GROUPAMA ASSISTANCE covers, up to a maximum of €50,000 per event, regardless of the number of people, the costs of search, rescue and rescue (including helicopter) incurred during rescue operations following the practice of any sporting or leisure activity. As regards the rescue costs, search and towing of surfing, windsurfing, jet skiing, the total amount is limited to €1,200.
3.2.5. TRANSPORT IN THE EVENT OF DEATH
GROUPAMA ASSISTANCE organises and pays for the transport of the Insured’s body from the place of burial to the place of burial in Metropolitan France or to the Insured’s Domicile.
GROUPAMA ASSISTANCE covers the additional costs necessary to transport the body, including the cost of a coffin up to €1,000.
The cost of accessories, ceremonies, burials or cremation in metropolitan France or in the country of residence of the Insured shall be borne by the families. In the event of temporary burial, GROUPAMA ASSISTANCE organizes and pays the cost of transporting the body of the Insured to the place of final burial in metropolitan France or to the Insured’s Domicile, after the expiry of the legal deadlines for exhumation.
GROUPAMA ASSISTANCE organizes and pays for the return to metropolitan France (or the country of residence of the Insured) to the place of burial of members of the Insured family participating in the same trip and being on the spot if
they cannot return by the means initially provided.
3.2.6. ADVANCE OF THE CRIMINAL BAIL AND PAYMENT
OF LEGAL COSTS (LEGAL ASSISTANCE)
This guarantee is only acquired outside the country of residence of the Member/Beneficiary.
If, in the event of an infringement of the legislation of the country in which the Member/Beneficiary is located and in the context of sporting activities, with the exception of the driving of motor vehicles, the latter is required by the local authorities to pay a criminal bond, the Assistants shall advance it up to the amount of 7 500 €. The reimbursement of this advance must be made within 1 month following the presentation of the reimbursement request by the Assistant.
This benefit does not cover legal proceedings initiated in the INSURER’s country of origin as a result of events occurring abroad.
GROUPAMA ASSISTANCE pays the legal fees of the legal representatives from whom the Insured may call up the amount mentioned in the table of benefits in Appendix 2 of these general conditions according to the coverage formula
Intentional offences do not qualify for the services “Advance
of criminal bond” and “Payment of attorney’s fees”.
3.2.7. OPTION: BAGGAGE GUARANTEE
(if the option is mentioned on your Certificate)
The Insurer covers the consequences of theft, loss or destruction of their luggage, personal objects and effects, professional equipment in the following circumstances:
– theft or loss during their journey when they have been entrusted to a transport company;
– theft, during the stay, as a result of the break-in of the premises or vehicle where they are located or an assault on the person carrying them;
– total or partial destruction resulting from fire, explosion, water damage or natural phenomena.
loss due to a natural event (storm, waterspout, hurricane, cyclone)
The maximum amount of coverage is set out in the table of benefits in Appendix 2 of these general conditions according to the coverage formula subscribed.
The flights must have been reported to a competent authority (police, gendarmerie, transport company, purser).
LUGGAGE, VALUABLES AND PROFESSIONAL EQUIPMENT
Suitcases, trunks, hand luggage, as well as their contents, insofar as they are clothing, effects, personal items and valuables taken or acquired by the Insured during the insured trip.
Jewellery, objects made with precious materials, precious
stones, pearls, watches, furs, cinematographic, photographic
and computer equipment.
Objects entrusted to the Insured by his employer in the
course of his professional activity.
LIMITS OF THE GUARANTEE
– For precious objects, pearls, jewellery, watches, furs,
as well as for any sound and/or image reproduction equipment and their accessories and portable microcomputers, the refund value may in no case exceed 30% of the amount of the guaranteed capital.
– If a private car is used, thefts are only covered if the luggage and personal effects are kept in the trunk of the vehicle locked and out of sight. When the vehicle is parked on the public road, the guarantee is forfeited only between 7 a.m. and 10 p.m.
THE FOLLOWING ARE EXCLUDED:
▪ DAMAGE RESULTING FROM THE DECISION OF A PUBLIC OR GOVERNMENTAL
▪ DAMAGE RESULTING FROM THE INHERENT DEFECT OF THE INSURED ITEM, NORMAL WEAR AND TEAR OR WEAR AND TEAR, WETTING OR POURING OF LIQUIDS, GREASY, COLOURING OR CORROSIVE MATERIALS FORMING PART OF THE INSURED BAGGAGE.
▪ CASH, CHEQUES, MAGNETIC OR CREDIT CARDS, TRANSPORT TICKETS, TITLES AND VALUABLES, DOCUMENTS RECORDED ON TAPES OR FILMS, PAPER DOCUMENTS OF ALL KINDS, KEYS.
▪ MUSICAL INSTRUMENTS, ART OBJECTS, ANTIQUES, COLLECTIONS AND GOODS.
▪ AUTOMOBILE ACCESSORIES, BICYCLES, WINDSURFING BOARDS AND, IN GENERAL, MEANS OF TRANSPORT AND SPORTS EQUIPMENT OF ALL KINDS.
▪ GLASSES, CONTACT LENSES, PROSTHESES AND DEVICES OF ALL KINDS.
▪ THE THEFT OF LUGGAGE, PERSONAL EFFECTS AND OBJECTS LEFT UNATTENDED IN A PUBLIC PLACE OR STORED IN A ROOM MADE AVAILABLE TO SEVERAL PERSONS.
▪ THEFT COMMITTED BY EMPLOYEES IN THE PERFORMANCE OF THEIR DUTIES.
▪ THE THEFT OF JEWELLERY WHEN IT HAS NOT BEEN PLACED IN A LOCKED SAFETY DEPOSIT BOX, WHEN IT IS NOT WORN.
▪ THE CONSEQUENCES OF THE INTENTIONAL MISCONDUCT OF NATURAL PERSONS HAVING THE STATUS OF INSURED.
▪ DAMAGE OR LOSS CAUSED BY CIVIL OR FOREIGN WAR, DECLARED OR NOT (ARTICLE L.121-8 OF THE CODE), UNLESS THE LIABILITY OF THE INSURER IS ESTABLISHED AT THE TIME OF THESE EVENTS.
▪ DAMAGE OR LOSS CAUSED BY EARTHQUAKES, RAIDS, VOLCANIC ERUPTIONS OR OTHER DISASTERS.
However, the following are guaranteed:
▪ The effects of natural disasters in accordance with Articles L. 125-1 to L. 125-6 of the Code
▪ The effects of wind due to storms, hurricanes and cyclones, in accordance with Article L. 122-7 of the Code.
– DAMAGE OR AGGRAVATION OF DAMAGE CAUSED BY:
– BY WEAPONS OR DEVICES INTENDED TO EXPLODE BY MODIFYING THE STRUCTURE OF THE NUCLEUS OF THE ATOM.
– BY ANY NUCLEAR FUEL, RADIOACTIVE PRODUCT OR WASTE. ▪ BY ANY OTHER SOURCE OF IONIZING RADIATION (IN PARTICULAR ANY RADIOISOTOPE). ▪ THE GENERATING EVENTS, DAMAGES OR LOSSES OF WHICH THE INSURER IS AWARE AT THE TIME OF SUBSCRIPTION OF THE CONTRACT AS LIKELY TO LEAD TO ITS APPLICATION.
The Insured shall be indemnified on the basis of proof and on the basis of the replacement value by equivalent objects of the same nature, obsolete deducted. In the first year following the purchase, the refund will be calculated at 75% of the purchase price. From the second year following the purchase, the refund will be reduced by 10% per year.
RECOVERY OF BAGGAGE, OBJECTS OR PERSONAL EFFECTS
As soon as he is informed, the Insured must notify the Insurer by registered letter. If the indemnity has not yet been paid, the Insured must take possession of the said baggage, objects or personal effects; the Insurer is then required to pay for any damage or missing items. If the benefit has already been paid, the Insured may opt, within fifteen days:
– For the abandonment of such baggage, objects or personal effects in favour of the Insurer.
– Either for the return of said baggage, objects or personal effects in return for the restitution of the indemnity received by the Insured, less, where applicable, the part of this indemnity corresponding to the damage or missing items. If the Insured has not made his choice known within fifteen days, the Insurer considers that the Insured has opted for abandonment.
CHAPTER 4. EXCLUSIONS COMMON TO ALL COVERAGES
The “INSURE YOUR SPORT” contract does not cover, in any case, damages and accidents caused by one of the following events:
– USE OF DRUGS, NARCOTICS, DRUGS NOT PRESCRIBED BY A DOCTOR;
– ALCOHOLIC STATE, INTENTIONAL ACTS, CONSCIOUS NON-COMPLIANCE WITH OFFICIAL PROHIBITIONS;
– SUICIDE OR ATTEMPTED SUICIDE, SELF-HARM.
– HANDLING OR POSSESSION OF MILITARY DEVICES, WEAPONS INCLUDING THOSE USED FOR HUNTING
– PARTICIPATION IN BETTING, CRIMES, BRAWLS (EXCEPT IN SELF-DEFENCE)
– ALL CASES OF FORCE MAJEURE MAKING IT IMPOSSIBLE TO PERFORM THE CONTRACT, IN PARTICULAR PROHIBITIONS IMPOSED BY LOCAL, NATIONAL OR INTERNATIONAL AUTHORITIES.
– CIVIL OR FOREIGN WARS, RIOTS, POPULAR MOVEMENTS, STRIKES, ACTS OF TERRORISM OR SABOTAGE.
– ANY MANIFESTATION OF RADIOACTIVITY;
– ACCIDENTS RESULTING FROM PARTICIPATION IN OFFICIAL COMPETITIONS ORGANISED BY A SPORTS FEDERATION ON A PROFESSIONAL OR PAID CONTRACT
BASIS AND TRAINING FOR SUCH COMPETITIONS.
– AIR SPORTS – UNLESS THE AIR SPORTS OPTION HAS
BEEN TAKEN OUT (*AS DEFINED IN APPENDIX 1 OF
THIS INFORMATION NOTICE TO THE ADP20181710
COLLECTIVE CONTRACT, WHICH IS THE GENERAL
– CIVIL OR FOREIGN WARS, RIOTS, POPULAR MOVEMENTS, STRIKES, ACTS OF TERRORISM OR SABOTAGE.
– ANY MANIFESTATION OF RADIOACTIVITY;
– ACCIDENTS RESULTING FROM PARTICIPATION IN OFFICIAL COMPETITIONS ORGANISED BY A SPORTS FEDERATION ON A PROFESSIONAL OR PAID CONTRACT BASIS AND TRAINING FOR SUCH COMPETITIONS.
– AIR SPORTS – UNLESS THE AIR SPORTS OPTION HAS BEEN TAKEN OUT (*AS DEFINED IN APPENDIX 1 OF THIS INFORMATION NOTICE TO THE ADP20181710
COLLECTIVE CONTRACT, WHICH IS THE GENERAL CONDITIONS),
– MOTOR SPORTS – EXCEPT WHEN THE MOTOR SPORTS OPTION HAS BEEN SUBSCRIBED (*AS DEFINED IN APPENDIX 1 OF THIS INFORMATION NOTICE TO THE ADP20181710 COLLECTIVE CONTRACT, WHICH IS THE GENERAL CONDITIONS)
– EXTREME SPORTS (*as defined in APPENDIX 1 of this INFORMATION NOTICE TO THE COLLECTIVE AGREEMENT ADP20181710 VALUING GENERAL CONDITIONS), NEVERTHELESS MOUNTAINEERING BELOW 6,000 METRES, CANYONING, RUNNING, CLIMBING, WHITE WATER SWIMMING AND RAFTING ARE ALLOWED.
– MOUNTAINEERING ABOVE 6000 METRES, BOBSLEIGH, SKELETON, CAVING, HUNTING DANGEROUS ANIMALS, BASEJUMP, OFF-PISTE SKIING WHEN AUTHORITIES ISSUE AVALANCHE RISK ALERT BULLETINS CLASS 3 TO 5.
CHAPTER 5. OBLIGATIONS IN THE EVENT OF A CLAIM
– In the event of a claim, it is important that we are promptly and fully informed of the circumstances in which it occurred and its possible consequences.
– The Insured or his successors in title, yourself if applicable, or any agent acting on their behalf are required to make, in writing or on the messaging system of the “INSURE YOUR SPORT” site at the following address: firstname.lastname@example.org the declaration of any claim within fifteen days at the latest of the date on which they became aware thereof.
– If the claim is not reported within the time limit provided for above, except in the event of unforeseen circumstances or force majeure, we may claim forfeiture of coverage if we can establish that the delay in reporting has caused us damage (Article L.113-2 of the Insurance Code).
– In addition, they must provide us with this declaration with all information on the seriousness, causes and circumstances of the incident and, if possible, the names and addresses of the witnesses and perpetrators responsible.
For Death and Permanent Infirmity resulting from an accident:
– The written statement specifying the circumstances of the accident, the names of the witnesses and, if applicable, the identity of the authority issuing the report if a report is drawn up and the transmission number.
– The certificate of the doctor, surgeon or hospital called upon to provide first aid and describing the injuries.
– The children’s birth certificates and a copy of the tax return proving that they are dependent on the Insured.
– The death certificate. – Documents establishing the status of the Beneficiary in the event of death, the name and address of the notary in charge of the succession.
– The notification of Permanent Social Security Infirmity.
– A medical certificate of Consolidation.
For medical expenses: – Medical expenses in the event of hospitalisation abroad outside the country of residence
In the event of an accident or illness requiring on-site hospitalization, the holder of the GROUPAMA ASSISTANCE identification card issued by the Insurer must present it to the hospital’s admission department.
The admission service will confirm the validity of the card with GROUPAMA ASSISTANCE, whose contact details appear on the card (by telephone or fax).
Payment of expenses is made directly to the hospital by GROUPAMA ASSISTANCE without the Insured having to make an advance payment.
The Subscribing Company, the Insured or his Successors undertake to take all necessary steps to obtain reimbursement of these expenses (in whole or in part) from the Social Security and/or other complementary bodies to which the Insured is affiliated and to immediately pay to GROUPAMA ASSISTANCE any sum received by it in this respect.
Important: This guarantee is forfeited after acceptance by GROUPAMA ASSISTANCE, within the limit of the amount indicated in the special conditions.
Medical expenses excluding hospitalisation abroad outside the country of residence
Reimbursement of medical expenses excluding hospitalisation is made upon the Insured’s return to his country of origin. He must provide all the necessary supporting documents.
The Subscribing Company, the Insured or its Successors undertake to take all necessary steps to obtain reimbursement of these expenses (in whole or in part) from the Social Security and/or other complementary bodies to which the Insured is affiliated.
The Insurer shall bear the additional costs reimbursed by the Social Security and/or other complementary bodies to which the Insured or his Successors are affiliated.
This additional payment is made up to the amount indicated
in the special conditions.
– Medical expenses in metropolitan France
Reimbursement of medical expenses in Metropolitan France is made on presentation, by the Subscriber or the Insured, of the medical certificate, sickness insurance, hospital bills, hospital bills and those of the doctor’s fees, Social Security statements and/or those of other complementary organisations as well as the reimbursement statements from which the Insured was a beneficiary.
For rescue and rescue costs:
For reimbursements to be made, the Insured must provide
the Insurer with the original of the detailed request for reimbursement of emergency and rescue expenses from the local
For the Luggage option if it is subscribed:
The participant’s claim report must be accompanied by the
– The original of the receipt for filing a complaint or
declaration of theft or loss issued by the competent
– Reserve forms from the carrier when the baggage
or objects have been lost during the time they were
in the carrier’s legal custody.
All documents in his possession justifying the existence and value of the property at the time of the
incident, as well as the importance of the damage
CHAPTER 6. SUBROGATION
In accordance with the provisions of article L. 121-12 of the insurance code, GROUPAMA is subrogated, to the extent of the indemnity paid by it, in the rights and actions of the insured against third parties. If we can no longer exercise this action, by your fact, we may be unloaded from all or part of our obligations to you.
CHAPTER 7. PLURAITY OF INSURANCE
The Member/Beneficiary is required to declare the existence of other insurance covering the same risks as the present contract when reporting a claim. When several insurances are taken out without fraud, each of them produces its effects within the limits of the coverages.
CHAPTER 8. REVIEW OF CLAIMS
1. In case of disagreement or dissatisfaction with the implementation of your contract, we invite you to inform MUTUAIDE ASSISTANCE by calling 01.41.77.45.50, by writing to email@example.com, or by post to the address:
MUTUAIDE ASSISTANCE SERVICE QUALITE CLIENTS 8/14 AVENUE DES FRERES LUMIERE 94368 BRY-SUR-MARNE CEDEX
for the assistance benefits listed below:
– Repatriation and medical transport
– Medical expenses
– Repatriation of accompanying persons
– Search and rescue costs
– Transport in the event of death
– Advance of criminal bond and payment of legal fees (Legal Assistance)
If the answer you receive does not give you satisfaction, you can send a letter to:
GROUPE SPECIAL LINES SERVICE RECLAMATIONS 6-8 RUE JEAN JAURES 92800 PUTEAUX
Or by email: firstname.lastname@example.org
If the disagreement persists, you can send a letter to:
GROUPAMA RHÔNE-ALPES-AUVERGNE SERVICE CONSOMMATEURS TSA 70019 69252 LYON CEDEX 09 GROUPAMA UNDERTAKES TO ACKNOWLEDGE RECEIPT OF YOUR LETTER WITHIN 10 WORKING DAYS. IT WILL BE PROCESSED WITHIN 2 MONTHS AT MOST. FINALLY, IF THE DISAGREEMENT STILL PERSISTS, YOU CAN GO BACK TO THE INSURANCE MEDIATION WHOSE CONTACT DETAILS CAN BE FOUND IN THE LETTERS RESPONDING TO YOUR COMPLAINT OR ON OUR WEBSITE.
1. In the event of disagreement or dissatisfaction with the implementation of your contract, we invite you to inform
Groupe Special Lines by writing to email@example.com for the insurance benefits
– Cancellation and interruption of stay
– Ski, snowboard, windsurfing, surfing
– Individual accident
If the answer you receive does not give you satisfaction, you
can send a letter to:
69252 LYON CEDEX 09
GROUPAMA undertakes to acknowledge receipt of
your letter within 10 working days. It will be processed
within 2 months at most.
If the disagreement persists, you may have recourse to
the insurance mediation, whose contact details are
given in the letters replying to your complaint or on
LIMITES APPLICABLES EN CAS DE FORCE MAJEURE
GROUPE SPECIAL LINES, GROUPAMA et MUTUAIDE ASSISTANCE cannot be held liable for failure to provide assistance resulting from force majeure or the following events: civil or foreign wars, notorious political instability, civil commotion, riots, acts of terrorism-reprisal, restrictions on the free movement of persons and goods, strikes, explosions, natural disasters, disintegration of the atomic nucleus, or delays in the provision of services resulting from the same causes.
CHAPTER 9. COMPETENT SUPERVISORY AUTHORITY
In accordance with the Insurance Code (Article L. 112-4) it is specified that the supervisory authority of GROUPE SPECIAL LINES, MUTUAIDE and GROUPAMA Assistance is the ACPR, 4 place de Budapest, CS 92459 ,75436 Paris Cedex 09.
CHAPTER 10. PRESCRIPTION
CHAPTER 11. EXERCISE OF THE RIGHT OF RENUNCIATION PROVIDED FOR IN ARTICLE L.112-2-1 OF THE INSURANCE CODE
CHAPTER 12. ATTRIBUTION DE JURIDICTION
The “INSURE YOUR SPORT” contract is subject to French law
CHAPTER 13. INFORMATION ET LIBERTÉ
In accordance with Act No. 78-17 of 6 January 1978 as amended relating to data processing, files and freedoms and European Regulation No. 2016/679/EU of 27 April 2016, the beneficiary is informed that the personal data that will be collected upon accession are essential for the implementation of the insurance guarantees defined in these general conditions.
This information is intended for the internal use of Groupe Special Lines, GROUPAMA and the broker as well as for the persons involved and responsible for the performance, management and execution of the contract within the limits of their respective at-tasks.
Special Lines Group, GROUPAMA and the broker undertake to take all necessary precautions to preserve the confidentiality and security of personal data (and in general all data) and in particular to prevent them from being distorted, damaged or communicated to unauthorised third parties and more generally to implement appropriate technical and organisational measures to protect personal data against accidental or unlawful destruction, accidental loss, alteration, dissemination or unauthorised access, in particular where the processing involves data transmission over a network and against any form of unlawful processing. They undertake to make the same commitments for their subcontractors.
Except in the cases set out above, the company undertakes not to sell, rent, transfer or give access to third parties to the data without the customer’s prior consent, unless it is obliged to do so for a legitimate reason (legal obligation, fight against fraud or abuse, exercise of the rights of the defence, etc.). The personal information collected is kept for a period of time that may not exceed the time limits provided for by the prescription in Article L. 114-1 of the Insurance Code unless: The insured has exercised, under the conditions set out below, one of the rights granted to him by law. The beneficiary has a right of access, communication, rectification and opposition to his data concerning him by contacting the correspondent Relais Informatique et Liberté du COURTIER ASSURE TON SPORT, 81 Chemin des Crans – 844100 BEDOIN ; the correspondent Relais Informatique et Liberté de GROUPE SPECIAL LINES 6/8 rue Jean Jaurès – 92800 PUTEAUX : firstname.lastname@example.org; or to the correspondent Relais Informatique et Liberté – GROUPAMA Rhône-Alpes-Auvergne TSA 70019 – 69252 LYON CEDEX 09. For any additional information or complaints, the customer can contact the Commission Nationale de l’Informatique et des Libertés (more information on www.cnil.fr).